1564P - A multivariate analysis of factors predicting survival in 70 patients with thymic carcinoma: Implications for treatment strategy

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Thymoma and Thymic Cancer
Presenter Masahiko Harada
Citation Annals of Oncology (2014) 25 (suppl_4): iv542-iv545. 10.1093/annonc/mdu357
Authors M. Harada1, Y. Okuma2, T. Hishima3, H. Horio4
  • 1Department Of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious-diseases Center Komagome Hospital, 113-0021 - Tokyo/JP
  • 2Department Of Thoracic Oncology And Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, 113-0021 - Tokyo/JP
  • 3Department Of Pathology, Tokyo Metropolitan Cancer and Infectious-diseases Center Komagome Hospital, 113-0021 - Tokyo/JP
  • 4Division Of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious-diseases Center Komagome Hospital, 113-0021 - Tokyo/JP

Abstract

Aim

Thymic carcinomas are considered to be more aggressive than thymomas and carry a worse prognosis. Although a multimodality treatment is made in many cases as for thymic carcinomas, optimal therapeutic strategy still remains controversial. In the present study, we attempted to clarify the prognostic factors based on the survival to establish suitable treatment strategy.

Methods

We performed a single-institution retrospective cohort study. Between June 1987 and October 2012, 70 patients were eventually given a diagnosis of thymic carcinoma. Data included patient demographics, stage, first treatment (e.g. chemotherapy (CT), chemoradiotherapy (CRT), and surgery (S)), pathologic findings, and outcomes.

Results

The overall 2- and 5-year survival rate was 61.9% and 36.4%, respectively; mean and median observation time was 30M and 24M, respectively. Two-year survival rates in patients treated with CT, CRT, and S group were 38.7, 52.4, and 80.5%, and 5-year survival rates in patients treated with CT, CRT, and S group were 17.4, 21.0, and 55% for all patients. S group showed significantly better prognosis than the others in overall stage (p=0.0006). Patients undergoing S, however, had similar survival compared with undergoing CT or CRT alone in stage IV a,b subset; CT vs. CRT (p=0.6598), CT vs. S (p=0.1159), CRTvs.S (p=0.3030). Univariate analysis among all patients revealed two significant prognostic factors (P <.05): stage by the Masaoka system and type of first treatment. Five-year survival rate in each factor were compared statistically by Kaplan–Meier's method; Masaoka stage II,III vs. IVa,b =72.7% vs.25.1% (p=0.0006), S vs. CT or CRT =55.0% vs.17.8% (p=0.0001). Multivariate analysis also revealed that both factors were statistically significant independent prognostic factor. The hazard ratio for death for being Masaoka stage II,III was 0.301?95%CI 0.115-0.787?(p=0.0149), for undergoing S was 0.442?95%0.239-0.818?(p=0.0094).

Conclusions

Our analyses indicated that stage by the Masaoka system and type of first treatment would have the prognostic impact. If complete excision is possible at earlier than Masaoka stage III, it may be cured completely. The role of debulking surgery at stage IV a,b was negative. Patient selection, accurate staging, and choice of anticancer drug with a high response rate may be critical to optimizing outcomes.

Disclosure

All authors have declared no conflicts of interest.